ABSTRACT
This chapter conveys the thinking about working with patients who present psychosomatic disorders. It addresses in particular how a primitive psychically unprocessed conflict is relived in the transference relationship via the psychosomatic symptom. Via their connection to unconscious phantasies, psychosomatic disorders are seen to be anchored in the mind and, therefore, available to analytical exploration. Bion’s ideas on the role of splitting, evacuation, and projective identification are complementary with Segal’s ideas of symbolic equation, by which unconscious phantasies are seen not to represent the object and are seen instead as an equation between the subject and the object to be represented. The early stages of unorganized experience that are lived through the body are sensations that also carry some primitive form of representations (phantasies encarnated) and via the introjection (internalization) of the mother’s skin/containing function provide the basis for ego functioning that will slowly enable the discrimination between internal and external.
